Individual
BRADLEY E KOCIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9880 ANGIES WAY STE 420, LOUISVILLE, KY 40241-2850
(502) 394-6200
(502) 394-6210
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36894
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350662
ANTHEM / NMA
—
01
—
000052155H
HUMANA / NMA
—
01
—
035903
SIHO / NMA
—
01
—
1191695
CHA / NMA
—
01
—
1839771
CIGNA / NMA
—
01
—
2689211000
PASSPORT ADVANTAGE / NMA
—
01
—
50009782
PASSPORT / NMA
—
05
—
64041445
—
KY
01
—
P00206866
RAILROAD MEDICARE / NMA
KY
Enumeration date
04/20/2006
Last updated
10/17/2024
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